Early childhood growth patterns and school-age respiratory resistance, fractional exhaled nitric oxide and asthma
Early childhood growth patterns and school-age respiratory resistance, fractional exhaled nitric oxide and asthma
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DOI：
10.1111/pai.12645
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发表时间：
2016-12-01
影响因子：
4.4
通讯作者：
Duijts, Liesbeth
中科院分区：
文献类型：
--
作者：
Casas, Maribel;den Dekker, Herman T.;Duijts, Liesbeth
背景：婴儿体重增加较多与肺功能降低和儿童哮喘风险增加有关。儿童早期高峰生长模式的作用尚不清楚。我们评估了个体衍生的儿童早期高峰生长模式与呼吸阻力、呼出一氧化氮分数、喘息模式和哮喘的相关性，直至学龄期。方法：我们在5364名儿童中进行了一项基于人群的前瞻性队列研究。使用0至3岁之间的重复生长测量来推导身高和体重峰值速度（分别为PHV和PWV）的标准差评分（s.d.s），以及体重指数（BMI）和肥胖峰值年龄。在6岁时测量呼吸阻力和呼出气一氧化氮分数。通过年度问卷调查前瞻性评估喘息模式和哮喘。结果：PHV越大，呼吸阻力越低[Z值（95%CI）：-0.03（-0.04，-0.01）/s.d.s增加]（n = 3382）。肥胖高峰期PWV和BMI增加与早期喘息风险增加相关[相对风险比（95%CI）：1.11（1.06，1.16），1.26（分别为1.11，1.43）]和持续喘息[相对风险比（95% CI）：1.09（1.03，1.16），1.37（1.17，1.60）]（分别为n = 3189和n = 3005）。儿童体重状况部分解释了这些关联。结论：PWV和BMI在肥胖高峰期对肺发育和学龄期喘息的风险至关重要。需要对老年人进行随访研究，以阐明这些影响是否会在以后的年龄持续存在。
Background: Greater infant weight gain is associated with lower lung function and increased risk of childhood asthma. The role of early childhood peak growth patterns is unclear. We assessed the associations of individually derived early childhood peak growth patterns with respiratory resistance, fractional exhaled nitric oxide, wheezing patterns, and asthma until school-age.Methods: We performed a population-based prospective cohort study among 5364 children. Repeated growth measurements between 0 and 3 years of age were used to derive standard deviation scores (s.d.s) of peak height and weight velocities (PHV and PWV, respectively), and body mass index (BMI) and age at adiposity peak. Respiratory resistance and fractional exhaled nitric oxide were measured at 6 years of age. Wheezing patterns and asthma were prospectively assessed by annual questionnaires. We also assessed whether any association was explained by childhood weight status.Results: Greater PHV was associated with lower respiratory resistance [Z-score (95% CI): -0.03 (-0.04, -0.01) per s.d.s increase] (n = 3382). Greater PWV and BMI at adiposity peak were associated with increased risks of early wheezing [relative risk ratio (95% CI): 1.11 (1.06, 1.16), 1.26 (1.11, 1.43), respectively] and persistent wheezing [relative risk ratio (95% CI): 1.09 (1.03, 1.16), 1.37 (1.17, 1.60), respectively] (n = 3189 and n = 3005, respectively). Childhood weight status partly explained these associations. No other associations were observed.Conclusions: PWV and BMI at adiposity peak are critical for lung developmental and risk of school-age wheezing. Follow-up studies at older ages are needed to elucidate whether these effects persist at later ages.